association between altered taste perceoption and nutritional outcomes among hemodialysis patients

Kidney Res Clin Pract 31 (2012) A16–A96A52

4ASSOCIATION OF FRAMINGHAM RISK SCORE WITH CHRONIC KIDNEYDISEASE – INSIGHT FROM NATIONAL HEALTH AND NUTRITIONEXAMINATION SURVEY 2003-2006Chien Yu Lina, Jou WeiLinaaa

Department of Internal Medicine, En Chu Kong Hospital, Taipei County,Taiwan

Background: The objective of this study was designed to illustrate theassociation between cardiovascular risk factors and CKD.

Methods: Subjects aged between 30 and 74 who participated in theNational Health and Nutrition Examination Survey (2003-2006) wereincluded for analysis, and Framingham risk score was calculated.Glomerular filtration rate was estimated (eGFR) by the Modification of Dietin Renal Disease (MDRD) Equation, and CKD was defined as eGFR less than60 ml/min/1.73m2.

Results: A total of 2524 men (mean age: 51713) and 2516 women(mean age: 50713) completed both cardiovascular risk assessment andrenal function evaluation. The proportion of Mexican Hispanic, otherHispanic, whites, blacks, and other races was 20.4%, 3.1%, 51.9%, 20.4%, and4.2%, respectively. The 10-year coronary risk, defined as high (4¼20%),intermediate (10�20%), and low (o 10%) was assigned to 374 (14.8%), 654( 25.9%), and 1496 (59.3%) male subjects, and to 44 (1.7%), 365 (14.5%), and2107 (83.7%) female subjects. The crude prevalence of CKD was 5.7% inmen and 7.2% in women. The markers of renal function including serumcreatinine, estimate GFR, percentage of CKD, urine albumin/creatinine ratioand percentage of microalbuminuria all correlated with the degree ofFramingham risk score. Male subjects in the high- and intermediate-CHD-risk group was positively associated with the risk of microalbuminuria insubjects with normal GFR ^ 90cc/min/1.73m2 (odds ratio:, 95% CI:, p o0.001, and OR:, 95% CI:, p o 0.001) as compared to those in the low-CHD-risk group. In the female, the odds ratio was (high risk vs. low risk, 95% CI:,p o 0.001) and (intermediate risk vs. low risk: 95% CI:, p o 0.001). Malesubjects in the high- and intermediate-CHD-risk group was positivelyassociated y

Conclusion: The population-based cohort has demonstrated thatFramingham risk score could be used as a potential predictor not only forfuture CHD but also for concurrent CKD.

http://dx.doi.org/10.1016/j.krcp.2012.04.466

143FINDING PHOSPHORUS CONTAINING ADDITIVES INMANUFACTURED FOODSLyn Lloyd, Lyn GillandersAuckland City Hospital, Auckland, New Zealand

Dietary phosphorous (P) intake is associated with an increased serumphosphate level which is a risk factor for cardiovascular disease andincreased mortality for people with chronic kidney disease. Dietaryrestriction of P is an important nutrition intervention as about 50% of dailyintake of P is from P–containing food additives. Educating patients on Padditives can effectively reduce serum P values over standard care.Avoidance can be achieved by reading the ingredient list to check for over20 P additives either by name or a number which is burdensome andconfusing. The purpose of this study was to search an existing NZManufactured Foods Database (5126 manufactured foods available in NZ)to obtain: 1. Listings of foods free from P additives; 2. Identification of foodgroups more likely to contain P additives; 3. Commonly used P additives

There were 1,920 foods (37%) that contained at least 1 P additive. Themost commonly used P additives were 450, 451, 322 and 1442.

Food Group

Most commonadditive used

Meat and Poultry Products

Cakes, Buns, Pastries

This reflects manufactured foods in NZ and it is likely that these resultscould be generalized to countries with similar food patterns and supplies.Quantitative data in manufactured foods is unlikely to be available to guidepatient choice so qualitative information of where to find P additives canbe helpful.

http://dx.doi.org/10.1016/j.krcp.2012.04.467

144ASSOCIATION BETWEEN ALTERED TASTE PERCEOPTION ANDNUTRITIONAL OUTCOMES AMONG HEMODIALYSIS PATIENTSKatherine Lynch, Rebecca Lynch, Gary CurhanSteven BrunelliBeth Israel Deaconess Medical Center, Boston, MA.Brigham and Women’s Hospital, Boston, MA

Taste impairment is prevalent among patients with end-stage renaldisease and may compromise nutritional status. There have been nostudies examining altered taste perception and nutritional outcomes. Weperformed a post-hoc analysis of data from the HEMO Study (n¼1745).Taste perception was assessed at baseline and then updated annually.Time-updated linear and logistic regression models were used to examinethe nutritional impact of altered taste perception and to evaluatepredictors of altered taste perception.

At baseline, 34.6% reported altered taste perception, which wasassociated with poorer nutritional indices. On longitudinal analysis, alteredtaste perception was independently associated with a persistently greaterneed for nutritional supplementation and subsequent reductions in serumalbumin (-0.03 g/dL; p¼0.02), serum creatinine (-0.22 mg/dL; p¼0.009),normalized protein catabolic rate (-0.05; p o 0.001), protein intake (-0.04¼ g/kg/day; p¼0.006), sodium intake (-90 mg/day; p¼0.02), and mid–arm muscle circumference (-0.29 cm; p¼0.05).

Among prevalent hemodialysis patients, altered taste perception wasfound to be associated with poorer indices of nutritional status at baselineas well as subsequent decline in nutritional indices over time

http://dx.doi.org/10.1016/j.krcp.2012.04.468

145INCREASED PREVALENCE OF MALNUTRITION AND REDUCED LEAN BODYMASS IN OVERWEIGHT/OBESE KIDNEY TRANSPLANT RECIPIENTSSylwia Ma"gorzewicz, Beata Czajka, Alicja Debska-Slizien,Micha" Chmielewski, Juan Jesus Carrero, Boles"aw Rutkowski

Overweight and obesity are common in subjects after kidneytransplantation. On the other hand, features of malnutrition are alsofrequently recognized in this group of patients. The aim of the study was toevaluate the prevalence of both abnormalities in a cohort of stable kidneyrecipients and to assess whether obesity precludes malnutrition intransplanted patients. We also investigated associations between thenutritional status, graft function and adipokines concentrations. The studywas performed in 80 prevalent kidney transplant patients and in a controlgroup which consisted of 23 healthy volunteers. Body composition (% of fat,lean body mass (LBM), water content) was measured by multifrequencybioelectrical impedance (Body Composition Manager). Nutritional statuswas determined by a 7–point Subjective Global Assessment (SGA),anthropometric measurements and s-albumin concentration. C–reactiveprotein (CRP), Il–6 and plasminogen activator inhibitor–1 (PAI–1) were usedas markers of inflammatory status. Concentration of leptin, adiponectin andvisfatin were measured by ELISA. Results: Mean age was 52.4713.9 years(45 men and 35 women). Diabetes mellitus was present in 29% (n¼23) ofthem. Mean time after transplantation (transplantation vintage) was82.5756.5 months (median¼73 months). Mean eGFR was 41.7714.9 ml/min (4 points MDRD), BMI was 25.774.2. Overweight was present in 41%of the patients and obesity in 14%. On the basis of SGA evaluation, signs of